Arthroscopic Diagnosis and Treatment of Osteochondral Talar Lesions Sterling CO

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Darrel Thomas Fenton, DO
(970) 522-2264
1405 S 8th Ave Ste 101
Sterling, CO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Kirksville Coll Of Osteo Med, Kirksville Mo 63501
Graduation Year: 1980
Hospital
Hospital: St Anthony Hosp Central, Denver, Co; East Morgan County Hosp, Brush, Co; Melissa Mem Hosp, Holyoke, Co; Sedgwick County Mem Hosp, Julesburg, Co; Sterling Regional Medcenter, Sterling, Co; Memorial Health Center, Sidney, Ne
Group Practice: Nor

Data Provided By:
Floyd Homer Pohlman, MD
(970) 522-2264
1405 S 8th Ave # 1191
Sterling, CO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ne Coll Of Med, Omaha Ne 68198
Graduation Year: 1971

Data Provided By:
Richard D Lazar, MD
(719) 471-2980
3010 N Circle Dr
Colorado Springs, CO
Business
Colorado Springs Orthopaedic Group
Specialties
Orthopedics

Data Provided By:
David James Schneider, MD
(303) 665-2603
80 Health Park Dr Ste 230
Louisville, CO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ks Sch Of Med, Kansas City Ks 66103
Graduation Year: 1995

Data Provided By:
Robert Marcus Baer, MD
(877) 512-4175
4725 Prospect St
Littleton, CO
Specialties
Orthopedics
Gender
Male
Education
Medical School: St Louis Univ Sch Of Med, St Louis Mo 63104
Graduation Year: 1999

Data Provided By:
Darrel Thomas Fenton
(970) 522-2264
1405 S 8th Ave
Sterling, CO
Specialty
Orthopedic Surgery

Data Provided By:
Dr. Michael Johnson
Johnson Chiropractic P.C.
(970) 522-3260
501 West Main Street
Sterling, CO
Specialty
Chiropractor
Conditions
Back pain,Chronic pain,Foot pain,Leg pain,Lower back pain,Migraine headaches,Neck pain,Upper back pain
Treatments
Chiropractic adjustment,Chiropractic care,Spinal manipulation
Proffesional Affiliation
American Chiropractic Association,Colorado Chiropractic Association

Gregg A Lindsey, DDS
(303) 770-1453
7200 E Dry Creek Rd Ste A105
Centennial, CO
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Loyd R Van Deventer, MD
(303) 526-2748
29220 Rudin Cir
Evergreen, CO
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
Todd M Raabe, MD
(903) 597-2663
1455 S Potomac St
Aurora, CO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Tx A & M Univ Coll Of Med, College Station Tx 77843
Graduation Year: 1991

Data Provided By:
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Arthroscopic Diagnosis and Treatment of Osteochondral Talar Lesions

Persistent ankle pain after an ankle sprain could be a sign of a condition called osteochondral lesion of the talus (OLT). The talus is a bone in the ankle between the calcaneus (heel bone) below and the tibia (shin bone) above.

The bottom of the tibia forms a dome over the top of the talus. With OLT, a piece of cartilage from the talus gets pinched by this dome. In more severe cases, a fragment of cartilage breaks off the talus but stays wedged in place. In the worst cases, the fragment is floating free in the joint space.

Other terms used to describe OLT include osteochondritis dissecans, transchondral fracture, talar dome fracture, and flake fracture. The condition is fairly uncommon. It is difficult to diagnose using X-rays, MRIs, or CT scans.

The authors of this study used arthroscopy to diagnose and treat OLT. They graded the condition based on severity as Grade I (mild) through Grade IV (severe). Treatment results were compared to see if outcomes were better for milder forms of the condition. Results showed that arthroscopic grading of OLT does predict final outcome after surgery. This is something that cannot be accomplished with X-rays or other more advanced forms of imaging.

Milder lesions without fragmentation had better results. Patients were more likely to have a good-to-excellent outcome without complications if the cartilage was not torn away. They were not able to compare results based on specific surgery done because there were too many different kinds of operations performed.

For example, some patients had holes drilled in the talus where the fragment had broken off. This procedure is called microfracture. It stimulates new growth of fibrocartilage. Other patients had the loose piece of cartilage removed (excision) with smoothing of the bone where the piece was broken off. And some patients had both excision and drilling.

Almost three-fourths of the group had good-to-excellent results. Most were able to return to all preoperative levels of activity. A few patients had complications such as plantar fasciitis, nerve pain or injury, or pain around the puncture wounds where the arthroscope entered through the skin. These problems all disappeared during the first six months of recovery.

Results of treatment did not appear to be linked with age, gender, or the side affected (right or left ankle). Delays between injury and surgery did not seem to make any difference in the final results. Worker's compensation patients did have poorer results compared with those who were not on worker's comp.

Follow-up was for at least five years. So it was possible to see if the long-term results changed over time. They found that more than one-third of the patients had a deterioration of their good results over time. Deep aching and pain with swelling recurred. Limited motion and instability occurred with degeneration of the joint. The reason(s) for this change was unknown.

The authors were unable to provi...

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